Structural factors of disability and ageing: spatial patterns in Mexico

BACKGROUND: Mexico is undergoing rapid population ageing, but its pace and intensity vary markedly across regions. This process unfolds amid deep social and economic inequalities, particularly in rural and marginalized areas where limited access to healthcare and social protection increases the risk of chronic disease, disability, and dependence. OBJECTIVE: To examine how demographic ageing, socioeconomic, and health conditions relate to disability prevalence among older adults at the municipal level, emphasizing the structural and territorial factors that constrain healthy ageing. METHODS: Using data from the 2020 Population and Housing Census and 2015-2019 mortality records, a municipal composite ageing index was developed to capture both the magnitude and structure of ageing. Spatial analytical techniques-Moran's I, Local Indicators of Spatial Association (LISA), and Geographically Weighted Regression (GWR)-were applied to identify spatial dependence and local variation. RESULTS: Bivariate Moran's I indicated limited global autocorrelation between ageing and disability, but LISA revealed pronounced local clusters. Ageing was more advanced in northern and central Mexico, whereas disability concentrated in the south and southeast. Lower educational attainment, reduced social protection coverage, and greater socioeconomic disadvantage were linked to highter disability prevalence. CONCLUSIONS: The findings show that ageing and disability are spatially patterned outcomes shaped by long-standing territorial inequalities. Recognizing these spatial dynamics is key to designing regionally differentiated, place-based public health and social policy responses that promote equitable ageing in Mexico.